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Successful conservative treatment of patients with MRI-verified meniscal lesions

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To follow a prospective cohort of consecutive patients with MRI-verified meniscal lesions to identify pre-treatment prognostic factors for long-term results following arthroscopic or conservative treatment.

Methods

In the course of 1 year, 291 patients with knee pain and clinically suspected of meniscal lesion were referred to the regional orthopaedic division and subjected to MRI and clinical examination by an experienced surgeon. Patients with MRI-verified meniscal lesions were treated according to an arthroscopy restrictive strategy meaning that treatment was initiated by conservative treatment. Arthroscopy was only performed if satisfying pain relief was not obtained. The Lysholm score and Knee Injury and Osteoarthritis Outcome Score (KOOS) were obtained at baseline and after 12–24 months. A multiple linear regression model was used to investigate which pre-treatment prognostic factors were associated with improvement in the KOOS subscale pain from baseline to follow-up.

Results

An MRI-verified meniscal lesion was found in 185 patients (64 %). Among these, 58 % were treated successfully by conservative treatment. A high KOOS subscale pain score at baseline was associated with less improvement from baseline to follow-up. Bucket-handle lesions were associated with larger improvement from baseline to follow-up compared to flap-tear lesions.

Conclusion

MRI findings and clinical status measured by KOOS subscale pain are prognostic for improvement among patients treated for MRI-verified meniscal lesions. Good results were observed for both operative and conservative treatment. The success rate for conservative treatment was 58 %.

Level of evidence

Prospective cohort study, Level II.

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Authors and Affiliations

  1. Orthopaedic Surgery Research Unit, Research and Innovation Center, Aalborg University Hospital, 15 Soendre Skovvej, 9000, Aalborg, Denmark

    Camilla Rams Rathleff, Christian Cavallius, Hans Peter Jensen, Ole Højgaard Simonsen, Sten Rasmussen & Svend Erik Østgaard

  2. Kaalund’s Orthopaedic Clinic, Aalborg, Denmark

    Søren Kaalund

Authors
  1. Camilla Rams Rathleff
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  2. Christian Cavallius
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  3. Hans Peter Jensen
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  4. Ole Højgaard Simonsen
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  5. Sten Rasmussen
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  6. Søren Kaalund
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  7. Svend Erik Østgaard
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Correspondence to Camilla Rams Rathleff.

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Rathleff, C.R., Cavallius, C., Jensen, H.P. et al. Successful conservative treatment of patients with MRI-verified meniscal lesions. Knee Surg Sports Traumatol Arthrosc 23, 178–183 (2015). https://doi.org/10.1007/s00167-013-2494-z

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  • DOI: https://doi.org/10.1007/s00167-013-2494-z

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